Provider Demographics
NPI:1164155693
Name:TITA, RELINDIS KOTKINGAH (APRN)
Entity Type:Individual
Prefix:
First Name:RELINDIS KOTKINGAH
Middle Name:
Last Name:TITA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 W I 44 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8729
Mailing Address - Country:US
Mailing Address - Phone:405-607-2233
Mailing Address - Fax:
Practice Address - Street 1:2301 W I 44 SERVICE RD STE 300
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8766
Practice Address - Country:US
Practice Address - Phone:405-607-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2111072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry